Provider Demographics
NPI:1306627534
Name:SUTKER, NOAH ISAAC
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:ISAAC
Last Name:SUTKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CHOATE CT UNIT 2
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2722
Mailing Address - Country:US
Mailing Address - Phone:410-660-7340
Mailing Address - Fax:
Practice Address - Street 1:2 CHOATE CT UNIT 2
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2722
Practice Address - Country:US
Practice Address - Phone:410-660-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program